For
a practising physician GI complaints come second only to Respiratory
complaints by a rough estimate of about 10 percent -12 percent of patient
attending a general physicians clinical, present with GI complaints. A
patient with GI complaints may present with many symptoms but commonest
are:-

1. Nausea and Vomiting

2. Dyspepsia or Flatulence

3. Constipation

4. Diarrhoea or Dysentery

Of all the above 4 symptoms an acute
presentation generally does not require much skills to diagnose or to
treat. There is generally a history available of dietary or alcoholic
indiscretion. A history of eating food which one is generally not used to.
A history of eating out. Dyspepsia a following an alcoholic binge or
attending a wedding party. Avoiding known aggravating factors and taking
simple corrective dietary measures usually suffices. It is a chronic,
persisting or recurrent complaints of one of the above that requires
meticulous care and deep thinking.

1. Nausea and Vomiting: Vomiting
involves fractionally distinct centers in the brain the vomiting center
and chemoreceptor trigger zone. The vomiting center may receive stimuli
from alimentary tract, cerebral center, vestibular apparatus, or for that
after from any organ system. Some of the common cause of vomiting which is
not responding to routine things are:-

A detailed history and proper clinical
examination along with necessary investigation will always clinic the
diagnosis in a case of severe or prolonged nausea and vomiting. While
treating such a case attention must be given to fluid and electrolyte
balance which may at times be more dangerous to patient then the vomiting
itself.

2. Constipation: Frequency of
defecation, volume of stool and consistency of stools vary greatly from
patient to patient. What is normal. May be a difficult question to answer.
The complaint of constipation should always be taken cautiously and one
should try to find out what is the patients attitude towards pattern of
bowel movements. A person is said to be constipated only if stools are
unexplainably delayed for days or they are usually dry, hard and difficult
to expel.

Most cases of constipation are
functional in origin or due to improper dietary habits like low intake of
fluids, fibre or consumption of highly refined dist. If there is a sudden
and unaccountable constipation with blood in stool it is most likely to
have an organic cause.

In therapy, proper dietary advise is as
essential as the medical line of treatment.

3. Dyspepsia: Is a term that covers
most of the different complaints arising out of stomach and duodenum. A
patient may present with burning in epigastrium, vague heaviness in
abdomen, epigastric distress, fullness following meals, belonging,
persistent anorexia or may have actual nausea vomiting. Some patient may
present with only complaint of passage of excessive gas per rectum.
Excessive balancing is usually due to aerophagia during eating or
drinking. Most complaints of distention of abdomen with pain may caused by
disordered mobility of the bowel rather than by excessive gas.

Most of the epigastric symptoms are a
sequel to colitis particularly Amoebic colitis and usually disappear after
due treatment is done.

Gastritis i.e. inflammation of gastric
mucosa presents an epigastric burning which is likely to be aggravated by
food. Most often there is history available either of injudicious drug
alcohol intake.

In some case there may be nausea and
vomiting which suggests acuteness or severity of gastritis.

Duodenal ulcer presents an epigastric
distress 45 to 60 minutes after meals or nocturnal pain (2 am), both
relieved by food, antacids or vomiting. Symptoms are usually chronic. Ba
Meal or endoscopy will confirm the diagnosis. Spontaneous exacerbations or
remissions are common.

A gastric ulcer on the other hand
present as epigastric distress on an empty stomach, relieved by food
antacids or vomiting but with early recurrence after vomiting. A history
of weight loss is often available. Epigastric tenderness is typically
defined as hunger pangs.

As earlier, diet plays an important
role in treatment of acid peptic disorders.

4. Diarrhoea and Dysentery: Diarrhoea
is defined as an increase in the frequency, fluidity and value of bowel
movements in a given individual.

"In a given individual" is a
very important part of this definition as normal bowel function varies
from individual to individual. A child may pass one motion for every milk
feed given, but if the consistency of the stool so formed, there is no
extra fluid, it is to be considered normal and warrants no treatment.
Diarrhoea occurs from the passages of secretion of water. Frequent
exacuation of blood, mucous or exudate is a syndrome often helping in the
diagnosis of colon involvement like ulcerative colitis.

Causes of diarrhoea: Most diarrhoea
conditions are self limiting. Due to improper dietary in take and pace
special diagnostic problems diagnostic evaluation. Following are some of
the causes.

Treatment In addition to specific
therapy, dietary restrictions, a replacement of fluid lost are two most
important factors that greatly help in reducing the morbidity due to
diarrhoea.

Agreement with Patient Essential

Do we not know very well that Silicea
will not cause suppuration about a foreign body unless it is in
homoeopathic agreement with the patient , i.e. similar to all his
symptoms?

Should we not also confess that if it
can be given on mental symptoms and does not remove a foreign body, that
these mental symptoms were not the true constitutionaly mental symptoms of
that patient, for if they were, it would have acted constitutional and
when so acting, it does cause suppuration about foreign bodies.